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On Saturday (15th June) I attended a Labour-hosted meeting in Gloucester, ‘Wither the NHS’. There were several speakers but I feel I must write about what the Socialist Health Association appears to stand for now. The SHA Director, Martin Rathfelder, made the point that the NHS is already full of private provision by asking those who were present to put their hand up if they had contact with someone working for a private company recently within the health service, explaining that GPs and pharmacists etc all work privately and even mentioning hospital food. I was surprised he didn’t mention the fact that the NHS doesn’t make paper towels!

This is rather disingenuous; most GPs have been contracted only to the NHS, not competing for patients and with the long-term welfare of the patient at heart. The patient expects to see the same GP for many years, not the 3-5 years of a privatised outsourcing. This is not even comparable to a company that has no interest in joined-up care or long-term welfare of people. GPs are not in the business of destabilising the ecosystem of the NHS or its ability to cross-subsidise. It sounded as though the SHA’s Director was trying to justify the Health & Social Care Act, particularly the s75 privatisation regulations. Are the SHA really pro the fragmentation of the NHS?

Martin pointed out that there was a survey that apparently said that 60% of the population were indifferent about who provides their care, in order to illustrate that it is not so important who provides our health care. He did not reference it but I can reference surveys that say that the public for the most part want their services run by the NHS, not just paid for by taxation. In Gloucestershire, remember, a huge public response to outsourcing of community services recently resulted in 96% of respondents preferring the publicly-owned option to even the phony ‘co-operative’ model my colleagues and our patients were offered.

I am concerned that attendees the meeting may fear the SHA no longer thinks it important that money put in to health provision should remain in health provision. That diverting it to line the pockets of share-holders is fine, as is paying for expenses that the public sector does not have to pay for (such as VAT). I really do hope the SHA believes that NHS properties should not be moved into PropCo to be rented back again at further expense.

I was relieved to hear Gabriel Scally put the purchaser/provider split argument down early on – I have seen an SHA article that suggests the split should remain, and that there is no proof it costs the amount quoted. Yet research commissioned by the DoH under the last government, estimated the split to cost 14% of the NHS budget. This internal market mechanism is the one major factor that allows the fragmentation of services – especially for the most vulnerable people with long-term conditions or mental health needs.

I felt, from the Director’s comments, that the SHA thinks health services do not need to be publicly-owned or provided – an argument we have seen made on the SHA site before, for example in an article suggesting that transparency was considered more important. Yes, of course transparency is important, but even if all health providers were private companies being more open and transparent than the NHS (which I doubt, privatisation thrives on secrecy) it won’t make health provision any better if they are being open but practising staff culls, cost-cutting, downgrading at the risk of safety and de-recognition of unions.

I have long admired the SHA and it has an incredible past in promoting, publicly and within the Labour Party, a need for a fair, socialist health system in this country, but I am deeply saddened by this apparent departure from its roots. I really did expect more of a challenge to the Conservative/Liberal attack on our health service.

The point I was making is that a lot of NHS services are provided, and always have been provided, by private contractors. There is a majority of the population who say that they don’t care who provides them, so long as they are free. We don’t say they are right to believe this. That is not to argue that those that are now publicly provided should now be privately provided, nor that there is no difference between public and private provision. But we cannot just assert that public services are better than private services. We have to convince people.

You should of course know that from the Tories own American research organisation, McKinsey that before they started to dismantle our NHS, it was ,number 17 in the world league tables for providing the high standard cheap services. The only European nation to be cheaper was Holland in this table.

Germany was the fourth most expensive and clearly does not provide the comprehensive service that our NHS does.

America of course sat at the top of the table as the most expensive in the world and fails to provide for 40% of it’s population, a disgrace for any modern health system in this day and age.

I think you do disservice to our NHS and give succour to to this vile Tory government, and I doubt that NYE BEVAN would applaud your vision of socialism.

As discussed on previous occasions there is in fact robust polling to illustrate a strong majority of the population don’t want to see more private companies in the NHS. It is true there are also polls that show a somewhat different message, as well, and it obviously depends to an extent on the way questions are asked. But it concerns me too, which polls the SHA chooses to highlight.

I think this post is excellent and raises concerns I have also had since becoming aware of the ‘socialist’ health association recently via blogs and twitter. Much of the content and comment I see, especially that on twitter, seems to come from a profoundly non-socialist position (apparently seeking to direct blame to patients or the public, rather than those with the power and wealth to structure society).

i should like to state i never knowingly write from a non-socialist position though!

have shared this excellent article of yours last night on Twitter, and will do so again.

i never blame patients tho, being a chronic user of the NHS being a disabled patient in the NHS myself since my 2 month coma in 2007, and indeed am followed by @debhazeldine @curethenhs @patientsfirstuk, as well as of course @mulberrybush (Diana Smith) whom I follow back and often have constructive conversations

Is the SHA compromised in what it can say because of its ties to the Labour Party? The LP could have a policy of reversing the Secretary of State’s responsibility towards the NHS ie restore the law to PROVING the NHS not merely promoting. That is why the NHS Reinstatement Bill http://www.nhsbill2015.org/ is so important yet not supported by the LP

We can only influence the Labour Party if they are prepared to enter into dialogue with us. Under Milburn we opposed Foundation Trusts but we had no influence at all. Now they talk to us. Whether we make any difference is a more difficult question.

So, when you say “our influence is not increased if they see us as opponents”, this an assertion, with – at least arguably – no basis in fact. For all you know, the “people outside the tent pissing in” have been more effective in shifting Labour policy than you are – after all, they might take the view that shifting to adopt the positions of those outside the tent might pull them into the tent. Those who are in the tent seem to hang around whatever terrible policies are thought up… perhaps worth thinking about what has changed since Milburn other than the personnel…

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The Socialist Health Association is a campaigning membership organisation. We promote health and well-being and the eradication of inequalities through the application of socialist principles to society and government. We believe that these objectives can best be achieved through collective rather than individual action.